Teeth grinding and clenching

What is teeth grinding?

Bruxism is defined as a parafunctional movement disorder, characterised by the involuntary clenching and/or grinding of teeth, usually while asleep. Extremely heavy forces can be exerted on the teeth during this process, ranging from the 5-25kg observed during normal function, such as eating, to 125kg noted during such involuntary biting. Some studies have even reported a maximum biting force of almost 450kg , demonstrating just how strong the muscles that close your jaw can be.

During normal function, such as speech and eating, a person will generally only expose their teeth to the heavy forces for a maximum of 17 minutes a day, therefore patients that suffer from bruxism may subject their teeth to substantially heavy forces for far lengthier periods of time than a non-bruxist.

When is teeth grinding a problem?

When you clench or grind your teeth at night time, you have no control over it, and are unable to reduce or stop the habit. Many patients find themselves clenching during the daytime as well, while concentrating or even when daydreaming. This almost continuous tension in the jaw can lead to jaw, facial and neck pain. Your dentist may ask you if you are aware of a habit like this, as it can be associated with ridges on the side of your tongue, crack lines and chips on your teeth, broken fillings, or temporary dental restorations repeatedly falling out. There are also cases of teeth splitting and requiring removal, broken veneers, crowns and even fracture of titanium dental implants. When you dentist has noticed signs like this, or you feel headaches or jaw pain may be related to a habit like this, it can be a good idea to have an assessment.

Unfortunately, some patients only become aware of the problem after breaking a tooth or dental restoration.

What causes teeth grinding?

The jury is still out on the exact cause or causes of teeth grinding. Stress, lifestyle habits, medications, medical conditions and your teeth not fitting together properly can all impact teeth clenching and grinding – and it may not be possible to address all of these factors immediately.

• Stressful periods such as examinations, family bereavement, divorce or marriage, relocating, overworking, excessive worrying or any other situation that can add extra pressure can intensify bruxism.
• Certain medications can contribute to teeth grinding, particularly certain classes of antidepressants
• Stimulants, like nicotine, caffeine and recreational drugs can contribute to bruxism, and excessive alcohol consumption doubles a person’s chances of clenching and grinding their teeth.

The aesthetic appearance can also bother some patients, as overuse of these muscles can lead to a square or wide jaw, which can masculinise female patients, and be unwelcome in excess by male patients.

Can teeth clenching and grinding affect the appearance of your face?

Fracture of teeth, fillings, crowns and even dental implants occurs over time, along with extensive wear of the teeth. This can cause a collapse of the mouth area, shortening the length of the face , and putting pressure on the jaw joint (temporomandibular joint). The muscles themselves also can grow larger (from all the exercise!) and the lower face can become wider, and give a strange, square shape to a male face, and masculinise a female face.

Dr Jennifer Owens has suffered from bruxism herself, and it is a particular passion of hers. She assesses each patient individually, and creates a treatment plan to address symptoms, and prevent further wear. This includes some or all of the following, depending on patient need:

• Nightguard
• Dietary supplements
• Referral for physical and other therapies
• Course of muscle relaxing injections